This is the first competitive renewal application for this clinical cardiovascular T32 training grant, which was initially funded in 2003. For this renewal application, we have made significant changes in our program in response to the Special Emphasis Panel critique of November 2002, in response to our initial experience with the program and in response to changes in cardiovascular medicine over the last 4 years. These program changes include dropping the use of training tracks, additions to our mentor faculty, and enhancements to our didactic course offerings. The 3 objectives of this program are to provide trainees with: 1) didactic training in the methods of clinical research, 2) a mentored research experience, and 3) training and experience in "survival skills" required for a successful academic career. Trainees spend 2 years in this program. During the funding period from 7/1/2003 to 6/30/2007, 5 trainees have completed the program and 3 are currently in the first year of training. Of the 5 who have finished the program, 3 have academic faculty appointments (2 at Duke, 1 at Emory). To date, this group of trainees has produced 16 first author publications in peer-reviewer journals and 4 of the trainees have applied for and been awarded extramural research funding. Formal training of participating mentors on the essentials of good mentoring will continue to be a major feature of our program. Interdisciplinary co-mentoring is standard in our training program. Twenty-eight faculty members representing 6 departments at Duke (Medicine, Surgery, Anesthesiology, Pediatrics, Behavioral Medicine/Psychiatry and Radiology) will participate as mentors in this program. During the course of each fellowship, several methods are used to monitor progress, including weekly meetings between the trainee and the primary mentor, and quarterly meetings for each trainee with the Program Director. Outcomes tracked include presentations at national meetings, peer-reviewed publications, and at least one grant application. We are requesting 6 trainee slots at the post-doctoral level, an increase from our currently funded level of 3 slots per year. In the application year 2006, we received 500 applications for Cardiovascular Training and interviewed 60 candidates. Of these, 52 were training grant eligible and 35 were seeking training in clinical research. We therefore feel that we have the critical mass of high quality candidates, outstanding mentors and a rich diversity of clinical research resources to support an increase in the size of our program.